Understanding SSDI Application Process and Appeals

We can help you understand the Social Security Disability application process. Whether it’s assisting with the completion and submission of your SSDI application or attend a hearing to advocate on your behalf, we are with you every step of the way—helping to make this complex and time-consuming process simpler for you and your loved ones.

Our goal is to move you as quickly and directly as possible to receiving your benefits. We excel at helping our clients obtain early awards, which means you likely won’t need to go through every step in order to receive your benefits. The chart below outlines the most common steps that a claims request may go through.

 

Initial Level Reconsideration Level Hearing Level Appeals Council Review Receiving Your Benefits

Initial Level—4 to 6 months

Step 1:

You will work with our Intake Specialists to gather all the information necessary to complete the required forms that enable us to represent you throughout the SSDI process.

Step 2:

Your Case Advocate will help you prepare and file your initial application for benefits. After it is filed, your claim will be reviewed and processed on its technical merit by your local Social Security Administration (SSA) office to ensure you meet initial eligibility requirements.

Step 3:

If your claim meets the initial requirements (sufficient work credits, citizenship requirements) a medical determination will be made by your state Disability Determination Services (DDS) agency. In order to verify your eligibility, the DDS office may provide additional questionnaires or request that you attend a Consultative Exam performed by a doctor of SSA’s choosing and paid for by SSA. Your Case Advocate will contact you with continuous updates as we monitor the progress of your application.

The Social Security Administration denies 65% of all claims at this level. In contrast, because we focus on getting early awards for our clients, most of the people we represent receive their award during this phase.

Step 4:

If your claim is denied, your case advocate will immediately begin the appeals process—we make sure you don’t miss the 60-day deadline that SSA gives you to complete your appeal.

Depending on the state that you live in, you may move on to the Request for Reconsideration or Request for Hearing phase.

Reconsideration Level—4 to 6 months

In most instances, the first level of appeal in the SSDI process is the Request for Reconsideration. Depending on which state you live in, if your initial SSDI claim is denied, we have 60 days from the date of the notice to file a Request for Reconsideration with SSA.

During this step your claim will be:

  • Technically processed by your local SSA office.
  • Medically determined by your state’s Disability Determination Services (DDS) agency.

When your case reaches DDS:

  • It will be reviewed by a different examiner who will assess your updated medical records and any changes to your health.

Because of this, you may:

  • Receive additional sets of questionnaires.
  • Be required to attend another Consultative Exam (CE).

The following states skip the Reconsideration level and go directly to a Request for Hearing:

Alabama, Alaska, California (some locations), Colorado, Louisiana, Michigan, Missouri, New Hampshire, New York, Pennsylvania


Currently, the average wait for a decision at this level is 4 to 6 months due to heavy volume of requests at SSA.

Hearing Level—12 to 18 months

In most instances, the second level of appeal in the SSDI process is the Request for Hearing. If your Reconsideration request is denied, we have 60 days from the date of the notice to file a Request for Hearing.

During this step your claim will be:

  • Technically processed by your local SSA office.
  • Medically determined by your local Office of Disability Adjudication and Review (ODAR).

At the ODAR your claim will be reviewed and assigned to an Administrative Law Judge (ALJ) prior to setting a hearing date.

Because of the heavy volume of requests at the SSA, the average processing time at this level is 12 to 18 months. During this time, your Case Advocate from The Advocator Group will:

  • Contact you to prepare for the hearing.
  • Conduct scheduled status checks and keep you updated on your claim.

At the hearing, your Hearing Advocate will offer compelling evidence before the ALJ as to how your disability impacts your ability to work.

It will take additional time for ODAR to process and mail your decision to you.

Appeals Council Review—12 to 18 months

In most instances, the third level of appeal in the SSDI process is a Request for Appeals Council Review.

When the hearing decision is appealed, the Appeals Council will:

  • Review the decision to determine if your claim was adjudicated properly by the Administrative Law Judge (ALJ).
  • Reverse or confirm the decision of the ALJ, or remand your case back to the Office of Disability Adjudication and Review (ODAR) for further review.

Receiving Your Benefits

When you are awarded Social Security Disability Insurance benefits, The Advocator Group will help you receive payment, coordinate any overpayment with your long-term disability insurance carrier, and ensure that you are prepared for your Medicare entitlement.

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